Bill Text: FL S0804 | 2017 | Regular Session | Comm Sub


Bill Title: Electronic Health Records

Spectrum: Bipartisan Bill

Status: (Failed) 2017-05-05 - Died in Appropriations [S0804 Detail]

Download: Florida-2017-S0804-Comm_Sub.html
       Florida Senate - 2017                              CS for SB 804
       
       
        
       By the Committee on Health Policy; and Senator Brandes
       
       
       
       
       
       588-02407-17                                           2017804c1
    1                        A bill to be entitled                      
    2         An act relating to electronic health records; amending
    3         s. 765.101, F.S.; redefining the terms “health care
    4         decision” and “incapacity” or “incompetent”; creating
    5         s. 765.114, F.S.; authorizing a person to donate his
    6         or her electronic health records, subject to certain
    7         requirements; authorizing electronic health records
    8         and qualified electronic health records to be donated
    9         to specified entities for specified purposes;
   10         providing a form for a uniform donor card; requiring
   11         electronic health records and qualified electronic
   12         health records donated by a health care surrogate or
   13         proxy to be de-identified; authorizing electronic
   14         health records and qualified electronic health records
   15         to contain a donor’s identifying information under
   16         certain conditions; authorizing a donor to amend the
   17         terms or revoke an electronic health records donation
   18         in specified manners; creating s. 765.1141, F.S.;
   19         requiring the Agency for Health Care Administration
   20         and the Department of Highway Safety and Motor
   21         Vehicles to develop and implement a program that
   22         encourages and authorizes persons to donate electronic
   23         health records and qualified electronic health records
   24         as part of a process of issuing and renewing
   25         identification cards and driver licenses; requiring
   26         specified information to be included in the donor
   27         registration card distributed by the department;
   28         requiring the agency and the department to develop and
   29         implement a program to identify donors through
   30         notations on identification cards and driver licenses;
   31         requiring the agency to provide certain supplies and
   32         forms, and the department to provide a recordkeeping
   33         system; prohibiting the department and agency from
   34         incurring liability in connection with the performance
   35         of certain acts; requiring the department to maintain
   36         a link on its website referring visitors to an
   37         electronic health records repository under certain
   38         circumstances; requiring rulemaking; amending s.
   39         765.203, F.S.; revising the suggested form for
   40         designation of a health care surrogate to expand
   41         health care decision authority of the health care
   42         surrogate; providing an effective date.
   43          
   44  Be It Enacted by the Legislature of the State of Florida:
   45  
   46         Section 1. Paragraph (e) is added to subsection (6) of
   47  section 765.101, Florida Statutes, and subsection (10) of that
   48  section is amended, to read:
   49         765.101 Definitions.—As used in this chapter:
   50         (6) “Health care decision” means:
   51         (e) The right of a health care surrogate or proxy to donate
   52  the principal’s electronic health records and qualified
   53  electronic health records, as defined in s. 408.051, upon the
   54  principal’s death to an approved medical or dental school,
   55  college, university, hospital, or repository that collects,
   56  stores, and shares de-identified electronic health records in
   57  the public domain for purposes of educating or developing
   58  diagnoses, treatment choices, policies, health care system
   59  designs, and innovations in order to improve health outcomes and
   60  reduce health care costs. For purposes of this paragraph, the
   61  term “approved” means approved by the Department of Health.
   62         (10) “Incapacity” or “incompetent” means the patient is
   63  physically or mentally unable to communicate a willful and
   64  knowing health care decision. For the purposes of making an
   65  anatomical gift or donating electronic health records or
   66  qualified electronic health records, the term also includes a
   67  patient who is deceased.
   68         Section 2. Section 765.114, Florida Statutes, is created to
   69  read:
   70         765.114Donating electronic health records and qualified
   71  electronic health records.—
   72         (1) A person may donate all or part of his or her
   73  electronic health records or qualified electronic health records
   74  by doing any of the following:
   75         (a) Signing an electronic health records donor card.
   76         (b) Indicating an intent to donate on his or her driver
   77  license or identification card issued by the Department of
   78  Highway Safety and Motor Vehicles. Revocation, suspension,
   79  expiration, or cancellation of the driver license or
   80  identification card does not invalidate the intent to donate.
   81         (c) Expressing a wish to donate in a living will or other
   82  advance directive.
   83         (d) Expressing a wish to donate in a will. The donation
   84  becomes effective upon the death of the testator without waiting
   85  for probate. If the will is not probated or if it is declared
   86  invalid for testamentary purposes, the donation is nevertheless
   87  valid to the extent that it has been acted upon in good faith.
   88         (e) Expressing a wish to donate in a document other than a
   89  will. The document must be signed by the donor in the presence
   90  of two adult witnesses, who must sign the document in the
   91  donor’s presence. If the donor cannot sign, the document may be
   92  signed by another person at the donor’s direction and in his or
   93  her presence and in the presence of two witnesses, who must sign
   94  the document in the donor’s presence. Delivery of the document
   95  during the donor’s lifetime is not necessary to make the intent
   96  to donate valid. The following form of written document is
   97  sufficient for any person to make a donation of electronic
   98  health records or qualified electronic health records for the
   99  purposes of this part:
  100  
  101            UNIFORM ELECTRONIC HEALTH RECORDS DONOR CARD           
  102  
  103  The undersigned hereby makes this health records donation, to
  104  take effect on death. The words and marks below indicate my
  105  desires:
  106  I give:
  107         1..... all electronic health records;
  108         2..... only the following electronic health records:
  109                 ...[Specify the health records]...                
  110  for the purpose of medical research or education.
  111  
  112  Signed by the donor and the following witnesses in the presence
  113  of each other:
  114  
  115  ...(Signature of donor)...        ...(Date of birth of donor)...
  116  ...(Date signed)...                       ...(City and State)...
  117  
  118  ...(Witness)...                                  ...(Witness)...
  119  ...(Address)...                                  ...(Address)...
  120  
  121         (2) The de-identified electronic health records or
  122  qualified electronic health records may be given to one or more
  123  donees that are accredited medical or dental schools, colleges,
  124  universities, hospitals, or repositories for the purposes of
  125  educating or developing diagnoses, treatment choices, policies,
  126  health care system designs, and innovations to improve health
  127  outcomes and reduce health care costs. Electronic health records
  128  or qualified electronic health records with a donor’s
  129  identifying information may be given to a donee upon written
  130  consent of the donor. The donees must be approved by the
  131  Department of Health and may be specified by name.
  132         (3) Any electronic health records or qualified electronic
  133  health records donated by a health care surrogate or proxy
  134  designated by the decedent pursuant to part II of this chapter
  135  must be de-identified, unless the donee provides written consent
  136  stating that his or her identifying information may be included
  137  with such records, and such donation must be made by a document
  138  signed by that person or made by that person’s witnessed
  139  telephonic discussion, telegraphic message, or other recorded
  140  message.
  141         (4) A donor may amend the terms of or revoke a donation of
  142  electronic health records or qualified electronic health records
  143  by any of the following means:
  144         (a) The execution and delivery to the donee of a signed
  145  statement witnessed by at least two adults, one of whom is a
  146  disinterested witness.
  147         (b) An oral statement that is made in the presence of two
  148  adult witnesses, one of whom is not a family member, and
  149  communicated to the donor’s family or attorney or to the donee.
  150  An oral statement is effective only if the medical or dental
  151  school, college, university, hospital, or repository has actual
  152  notice of the oral amendment or revocation.
  153         (c) An oral statement made during a terminal illness or
  154  injury addressed to the primary physician, who must communicate
  155  the revocation of the gift to the medical or dental school,
  156  college, university, hospital, or repository.
  157         (d) A signed document found on or about the donor’s person.
  158         (e) A later-executed document of donation which amends or
  159  revokes a previous health records donation or portion of a
  160  health records donation, either expressly or by inconsistency.
  161         (f) The destruction or cancellation, with the intent to
  162  revoke the donation, of the document that indicates the intent
  163  to donate or the destruction or cancellation of that portion of
  164  the document which indicates the intent to donate.
  165         Section 3. Section 765.1141, Florida Statutes, is created
  166  to read:
  167         765.1141Electronic health records donations as part of
  168  driver license or identification card process.—
  169         (1) The Agency for Health Care Administration and the
  170  Department of Highway Safety and Motor Vehicles shall develop
  171  and implement a program encouraging and authorizing persons to
  172  donate electronic health records and qualified electronic health
  173  records, as defined in s. 408.051, as a part of the process of
  174  issuing and renewing identification cards and driver licenses.
  175  The donor registration card distributed by the department must
  176  include the information and signatures required in the uniform
  177  electronic health records donor card under s. 765.114(1)(e) and
  178  such additional information as determined necessary by the
  179  department. The department shall also develop and implement a
  180  program to identify donors which includes notations on
  181  identification cards and driver licenses to clearly indicate the
  182  individual’s intent to donate his or her electronic health
  183  records. The agency shall provide the necessary supplies and
  184  forms using appropriated funds or contributions from interested
  185  voluntary, nonprofit organizations. The department shall provide
  186  the necessary recordkeeping system using appropriated funds. The
  187  department and the agency do not incur liability in connection
  188  with the performance of any act authorized in this section.
  189         (2) The department shall maintain an integrated link on its
  190  website referring a visitor renewing an identification card or a
  191  driver license or conducting other business to an electronic
  192  health records repository if available.
  193         (3) The department, after consultation with and concurrence
  194  by the agency, shall adopt rules to implement this section
  195  pursuant to chapter 120.
  196         Section 4. Section 765.203, Florida Statutes, is amended to
  197  read:
  198         765.203 Suggested form of designation.—A written
  199  designation of a health care surrogate executed pursuant to this
  200  chapter may, but need not be, in the following form:
  201  
  202                DESIGNATION OF HEALTH CARE SURROGATE               
  203  
  204  I, ...(name)..., designate as my health care surrogate under s.
  205  765.202, Florida Statutes:
  206  
  207  Name: ...(name of health care surrogate)...
  208  Address: ...(address)...
  209  Phone: ...(telephone)...
  210  
  211  If my health care surrogate is not willing, able, or reasonably
  212  available to perform his or her duties, I designate as my
  213  alternate health care surrogate:
  214  
  215  Name: ...(name of alternate health care surrogate)...
  216  Address: ...(address)...
  217  Phone: ...(telephone)...
  218  
  219                    INSTRUCTIONS FOR HEALTH CARE                   
  220  
  221  I authorize my health care surrogate to:
  222         ...(Initial here)... Receive any of my health information,
  223  whether oral or recorded in any form or medium, that:
  224         1. Is created or received by a health care provider, health
  225  care facility, health plan, public health authority, employer,
  226  life insurer, school or university, or health care
  227  clearinghouse; and
  228         2. Relates to my past, present, or future physical or
  229  mental health or condition; the provision of health care to me;
  230  or the past, present, or future payment for the provision of
  231  health care to me.
  232  I further authorize my health care surrogate to:
  233         ...(Initial here)... Make all health care decisions for me,
  234  which means he or she has the authority to:
  235         1. Provide informed consent, refusal of consent, or
  236  withdrawal of consent to any and all of my health care,
  237  including life-prolonging procedures.
  238         2. Apply on my behalf for private, public, government, or
  239  veterans’ benefits to defray the cost of health care.
  240         3. Access my health information reasonably necessary for
  241  the health care surrogate to make decisions involving my health
  242  care and to apply for benefits for me.
  243         4. Decide to make an anatomical gift pursuant to part V of
  244  chapter 765, Florida Statutes.
  245         5.Donate my electronic health records and qualified
  246  electronic health records, as defined in s. 408.051, Florida
  247  Statutes, to one or more accredited medical or dental schools,
  248  colleges, universities, hospitals, or repositories, approved by
  249  the Department of Health, to share my de-identified health
  250  records for purposes of developing diagnoses, treatment choices,
  251  policies, health care system designs, and innovations to improve
  252  health outcomes and reduce health care costs.
  253         ...(Initial here)... Specific instructions and
  254  restrictions: ..................................................
  255  ................................................................
  256  ................................................................
  257  
  258  While I have decisionmaking capacity, my wishes are controlling
  259  and my physicians and health care providers must clearly
  260  communicate to me the treatment plan or any change to the
  261  treatment plan prior to its implementation.
  262  
  263  To the extent I am capable of understanding, my health care
  264  surrogate shall keep me reasonably informed of all decisions
  265  that he or she has made on my behalf and matters concerning me.
  266  
  267  THIS HEALTH CARE SURROGATE DESIGNATION IS NOT AFFECTED BY MY
  268  SUBSEQUENT INCAPACITY EXCEPT AS PROVIDED IN CHAPTER 765, FLORIDA
  269  STATUTES.
  270  
  271  PURSUANT TO SECTION 765.104, FLORIDA STATUTES, I UNDERSTAND THAT
  272  I MAY, AT ANY TIME WHILE I RETAIN MY CAPACITY, REVOKE OR AMEND
  273  THIS DESIGNATION BY:
  274         (1) SIGNING A WRITTEN AND DATED INSTRUMENT WHICH EXPRESSES
  275  MY INTENT TO AMEND OR REVOKE THIS DESIGNATION;
  276         (2) PHYSICALLY DESTROYING THIS DESIGNATION THROUGH MY OWN
  277  ACTION OR BY THAT OF ANOTHER PERSON IN MY PRESENCE AND UNDER MY
  278  DIRECTION;
  279         (3) VERBALLY EXPRESSING MY INTENTION TO AMEND OR REVOKE
  280  THIS DESIGNATION; OR
  281         (4) SIGNING A NEW DESIGNATION THAT IS MATERIALLY DIFFERENT
  282  FROM THIS DESIGNATION.
  283  
  284  MY HEALTH CARE SURROGATE’S AUTHORITY BECOMES EFFECTIVE WHEN MY
  285  PRIMARY PHYSICIAN DETERMINES THAT I AM UNABLE TO MAKE MY OWN
  286  HEALTH CARE DECISIONS UNLESS I INITIAL EITHER OR BOTH OF THE
  287  FOLLOWING BOXES:
  288  
  289  IF I INITIAL THIS BOX [....], MY HEALTH CARE SURROGATE’S
  290  AUTHORITY TO RECEIVE MY HEALTH INFORMATION TAKES EFFECT
  291  IMMEDIATELY.
  292  
  293  IF I INITIAL THIS BOX [....], MY HEALTH CARE SURROGATE’S
  294  AUTHORITY TO MAKE HEALTH CARE DECISIONS FOR ME TAKES EFFECT
  295  IMMEDIATELY. PURSUANT TO SECTION 765.204(3), FLORIDA STATUTES,
  296  ANY INSTRUCTIONS OR HEALTH CARE DECISIONS I MAKE, EITHER
  297  VERBALLY OR IN WRITING, WHILE I POSSESS CAPACITY SHALL SUPERSEDE
  298  ANY INSTRUCTIONS OR HEALTH CARE DECISIONS MADE BY MY SURROGATE
  299  THAT ARE IN MATERIAL CONFLICT WITH THOSE MADE BY ME.
  300  
  301  SIGNATURES: Sign and date the form here:
  302  ...(date)...                              ...(sign your name)...
  303  ...(address)...                          ...(print your name)...
  304  ...(city)... ...(state)...
  305  
  306  SIGNATURES OF WITNESSES:
  307  First witness                                     Second witness
  308  ...(print name)...                            ...(print name)...
  309  ...(address)...                                  ...(address)...
  310  ...(city)... ...(state)...            ...(city)... ...(state)...
  311  ...(signature of witness)...        ...(signature of witness)...
  312  ...(date)...                                        ...(date)...
  313         Section 5. This act shall take effect July 1, 2017.

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